R21HD107311

An intervention to promote healthy relationships among transgender and gender expansive youth - project summary.

Transgender and gender expansive (TGE) youth identify as a gender different from their sex at birth. Research tends to define this group based on high rates of sexually transmitted infections (STIs), sexual risk behaviors, violence exposures, and other health outcomes.

Little work has used a supportive, resilience-based framework or a human-centered approach. We conducted preliminary qualitative/co-design studies to understand sexual health content needs and format/design preferences.

Content areas recommended by TGE youth, their families, providers, and/or advocates include:

A) Youth/providers noted that puberty can produce dysphoria for TGE adolescents and that information/tools would be beneficial.

B) Participants asked for non-judgmental information about STI risks and prevention.

C) Youth/providers asked for content around contraception that clarifies that gender-affirming medical interventions do not prevent unintended pregnancies.

D) Participants recommended destigmatizing and normalizing diversity in sexual attractions and desires.

E) TGE youth raised disclosure of TGE identity as a unique challenge and asked for communication skills training to help them maintain agency over when and how to disclose.

F) Participants described difficulties navigating partner consent because it is often described in heteronormative, binary terms in sexual education classes.

TGE youth also described favoring written materials for more fact-based content on contraception and STIs, interactive formats for content that requires personalization by gender and/or degree of medical transition, and multimedia approaches emphasizing lived experience perspectives for information around desire, gender identity disclosure, and consent.

Participants also provided design guidance (e.g., use of a covert color palette that would not unwantedly disclose users' transgender status in public) and specific features (e.g., blacklisting functions to protect the user from triggering content; robust search and filter system to easily locate information specific to an individual's needs).

Based on these themes, we co-designed a paper intervention prototype with TGE youth. In this proposal, we will engage a youth advisory board and community consultants to co-design a fully functional online interactive sexual education tool (OISET) with TGE youth (AIM 1A) and conduct cognitive interviews to refine select survey tools and ensure gender-affirming intervention effect measurement in a future R01 (AIM 1B).

We will then conduct an unbalanced, randomized controlled pilot study with 40 youth (30 intervention:10 control) to refine content and establish feasibility of the OISET and data collection protocols/procedures (AIM 2). Primary outcomes will be intervention usability/feasibility/appropriateness/acceptability and study feasibility.

We will collect baseline, post-intervention, and 3-month data on knowledge; general/sexuality-specific self-efficacy; partner communication; risky sexual behaviors; social support; and resilience.

This project is innovative, rigorous, and responsive to NICHD/NINR/SGMRO priorities. It will result in the first evidence- and strengths-based online sexual health intervention for TGE youth.

Seattle Children's Hospital

TO CONDUCT AND SUPPORT LABORATORY RESEARCH, CLINICAL TRIALS, AND STUDIES WITH PEOPLE THAT EXPLORE HEALTH PROCESSES. NICHD RESEARCHERS EXAMINE GROWTH AND DEVELOPMENT, BIOLOGIC AND REPRODUCTIVE FUNCTIONS, BEHAVIOR PATTERNS, AND POPULATION DYNAMICS TO PROTECT AND MAINTAIN THE HEALTH OF ALL PEOPLE. TO EXAMINE THE IMPACT OF DISABILITIES, DISEASES, AND DEFECTS ON THE LIVES OF INDIVIDUALS. WITH THIS INFORMATION, THE NICHD HOPES TO RESTORE, INCREASE, AND MAXIMIZE THE CAPABILITIES OF PEOPLE AFFECTED BY DISEASE AND INJURY. TO SPONSOR TRAINING PROGRAMS FOR SCIENTISTS, DOCTORS, AND RESEARCHERS TO ENSURE THAT NICHD RESEARCH CAN CONTINUE. BY TRAINING THESE PROFESSIONALS IN THE LATEST RESEARCH METHODS AND TECHNOLOGIES, THE NICHD WILL BE ABLE TO CONDUCT ITS RESEARCH AND MAKE HEALTH RESEARCH PROGRESS UNTIL ALL CHILDREN, ADULTS, FAMILIES, AND POPULATIONS ENJOY GOOD HEALTH. THE MISSION OF THE NICHD IS TO ENSURE THAT EVERY PERSON IS BORN HEALTHY AND WANTED, THAT WOMEN SUFFER NO HARMFUL EFFECTS FROM REPRODUCTIVE PROCESSES, AND THAT ALL CHILDREN HAVE THE CHANCE TO ACHIEVE THEIR FULL POTENTIAL FOR HEALTHY AND PRODUCTIVE LIVES, FREE FROM DISEASE OR DISABILITY, AND TO ENSURE THE HEALTH, PRODUCTIVITY, INDEPENDENCE, AND WELL-BEING OF ALL PEOPLE THROUGH OPTIMAL REHABILITATION.

93.865 - Child Health and Human Development Extramural Research

National Institute of Child Health and Human Development (NICHD) [HHS - NIH]

Washington United States

State-Wide

NIH Exploratory/Developmental Research Grant Program (Parent R21 Clinical Trial Required) (PA-20-194)

Amendment Since initial award the End Date has been extended from 08/31/24 to 08/31/25 and the total obligations have increased 112% from $215,704 to $456,997.